Meet the team: East of England Citizens’ Senate
Chair, East of England Citizens' Senate. Patient & Public Involvement Representative
Eastern Academic Health Science Network
- England - East
Cofounder of PROMISE; PPI Advisor to CLAHRC EoE Board; Member of the EAHSN's Patient Safety Collaborative; Trustee of National Mind; Member of Clinical Advisory Group for the local STP programme.
Cambridgeshire and Peterborough NHS Foundation Trust (CPFT)
- England - East
- Mary Newton
- Joanna Yellon
- Paula Wilkinson
- Adrian Pensose
- Tracey Johns
Researchers from Manchester, Sheffield and York universities, estimate that drug errors cause 700 deaths a year and could also be a factor in between 1,700 and 22,300 other ones.
Ø 237 million drug mistakes are made each year
Ø 28% could cause moderate or severe harm
Ø 22,300 more deaths could be related to mistakes
Our proposal is to obtain funding for a pilot study to assess feasibility of this peer support initiative to reduce harm by misuse of medication.
A rapid review commissioned by the Eastern Academic Health Science Network (EAHSN) in April 2018 revealed that there was little evidence about the best way to recruit and train peer support workers. In addition, only limited research has been done to compare the pros & cons of different types of training. An evidence scan commissioned by the Health Foundation in 2013, evidenced that patients were apprehensive about challenging and questioning clinicians about their medication and were more likely to talk openly about their fears and concerns to their peers. In line with the Royal Pharmaceutical Society’s best-practice guidance for medication optimisation, we propose an innovative approach to working with Patient Participation Group (PPG) representatives to help embed medication optimisation into clinical practice. The peer support workers will not give clinical advice, but will help patients understand the importance of taking their medication as directed. They will signpost them to access the most appropriate source of advice.
We intend to draw on the existing Medication Waste campaign, developed by Mid Essex CCG. We will integrate medication safety and waste, in order to optimise medicine use to achieve our objectives and health benefits. We will identify potential peer support workers from the PPGs with the right skills to coproduce the training programme. They will also develop a learning and support package, which will include informational leaflets, booklets and posters. Patients attending GP surgeries will be offered the opportunity to talk to a peer support worker and discuss any concerns about their medication. The peer support worker will not offer any clinical advice but will make an assessment of their level of knowledge and confidence about their medication. They will then be signposted to appropriate services if necessary e.g. pharmacy for Medicine Use Reviews and practice Nurse Prescriber etc.
- Reducing harm caused by misuse of medicines
- Promoting shared decision making and understanding medication risks & benefits
- Enhancing patient experience and empowering patients to better manage their condition
- Avoiding waste and improving cost efficiency
- Contributing to the learning and benefits of peer support through empirical evidence
- Developing and testing methods of measuring the effectiveness of peer support and coproducing effective tools for training peer supporters
- Reducing demand for GP appointments and pressure on services
A full evaluation report and robust recommendations will inform and develop the campaign, which will be tested with the PPGs, before campaign launch. A medication safety toolkit will then be developed which will also include the key materials required to support the peer workers. The PPGs at selected GP Practices will be involved with co-designing and developing the campaign, which they themselves can deliver. The pilot will explore optimum measurement criteria e.g. qualitative questions and POET/PAM/Wellness measures.
- It embeds patient views and involvement at the heart of the campaign
- It promotes NHS values and objectives
Collaborators / Partners
- Eastern Academic Health Science Network will provide guidance on governance and improvement methodology
- NIHR Collaboration for Leadership in Applied Health Research & Care (CLAHRC EoE)
- Mid Essex CCG (TBC)
- Cambridge & Peterborough Foundation Trust, expertise in peer support, training and evaluation (TBC)
- Paula Wilkinson, FRPahrmS, Chief Pharmacist & Deputy Director of Primary Care, NHS Mid Essex
- COPE (Scotland)
Over the course of several workshops, members of the Citizens’ Senate identified the most common risks for causing patient harm in primary care, particularly improper use of medication and poor knowledge about their medicines. This was consistent with findings published by researchers in 2018 from Manchester, Sheffield and York universities.
Benefits to the Q Community
The project will build on the findings from the first Q Improvement lab, which explored ways to make peer support available to all. The initiative will provide evidence about the best way of utilising a structured and formal peer support model to empower patients and increase their ability to self-manage. The programme is replicable and can be modified to reflect locality needs, as Sustainability & Transformation Partnerships (STP) and commissioners integrate primary and social care. The benefits and lessons learnt will be shared with the Q Community to promote more widely. We intend to publish our progress and challenges through webinars, QSIGs and Q events for easier learning, adoption and spread.
Meet the team
How you can contribute
- Does anyone know of any research evidence in primary care that informs models of peer support in medicine safety?
- Is there any expertise or advice you can bring to our proposal?
Peer Support OutlinePlan v1.3 Aug 2018 (PDF, 806KB)
This is a great project because…
The team propose an interesting way to use peer support in this important area of patient safety. It is well linked into national initiatives which should help it have wider impact.
By the time of the event we encourage the project team to think more about…
This is an exciting proposal and we are interested to see whether the concept actually works! It is ambitious for the amount of funding so there will be need to be a clear focus on how the project is delivered and making sure the learning is captured as it progresses.